ABSTRACT
Disconnected pancreatic duct syndrome (DPDS) is a rare but important complication of acute necrotizing pancreatitis (ANP). This syndrome presents as a circumferential discontinuity of the ductal anatomy between the pancreatic secreting tissue and the gastrointestinal tract. Most cases do not respond to conservative therapy and require surgical intervention. This condition is a challenge for the medical team, given the delay in diagnostic suspicion and the need for multimodal therapeutical approach. Acute pancreatitis has been reported in patients with COVID-19, although a direct cause and effect relationship has not yet been established. Whether infection with new Coronavirus can contribute as worsen-ing factor in acute pancreatitis due to viral tropism to pancreatic cells is not known. We present the case of a 44-year-old male patient with a diagnosis of acute necrotizing pancreatitis who evolved with disconnected duct syndrome due to necrosis of the central region of the pancreas. He performed multiple drainages of the collections and necrosectomy, with persistent pancreatic fistula, eventually requiring caudal pancreatec-tomy. This patient had a diagnosis of COVID-19 and thromboembolic events during hospitalization, constituting a challenge for treatment. He presented a good postoperative clinical evolution, being discharged 5 months after admission. Disconnect duct syndrome frequently presents as a treatment challenge. These patients are severe and an overlapping COVID infection acts as an important aggravating factor. Whether the infection is related to pancreatitis, either in its genesis or acting as a worsening factor has not yet been established.(Cite this article as: Capaverde LH, Hinrichsen LB, Fetzner B, Pieta MP, Cardoso AM, Costa LB, et al. Acute necrotizing pancreatitis and discon-nected pancreatic duct syndrome associated with COVID-19. Chirurgia 2022;35:241-5. DOI: 10.23736/S0394-9508.21.05347-X)